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A small tumor in the head of pancreas obstructing the terminal bile duct. This was an adenocarcinoma.

Discussion

This case here highlights the importance of finding an abruptly terminating bile duct. The additional finding of an associated mass suggets that the disease process could either be a cholangiocarcinoma of the terminal duct or a pancreatic tumor. Further imaging would help to arrive at a final diagnosis.

Follow Up

Further imaging [ERCP and MRI] was performed which showed a small mass in the head of the pancreas, just next to the terminal portion of the CBD, obstructing it. This mass proved to be an adenocarcinoma and the patient was operated upon.